The clinical manifestations of trigeminal neuralgia are characteristic. If you experience recurrent episodes of severe unilateral facial tearing-like pins and needles pain, you should consider whether you have trigeminal neuralgia. Trigeminal neuralgia is usually sudden, often triggered by actions such as chewing, brushing teeth, washing face, talking or even opening mouth (called trigger point), and the attack time varies from a few seconds or minutes to several hours, while the inter-episode period is completely normal. Many patients are afraid to eat, wash their faces, brush their teeth and speak because of the fear of pain, which seriously affects their normal life and brings great pain to patients, even painful. The diagnosis of trigeminal neuralgia is mainly based on clinical manifestations, and it is often easy to make a judgment based on typical symptoms, but some patients treat trigeminal neuralgia as “toothache” and still have pain after tooth extraction, and some have acupuncture, take Chinese medicine, and some take painkillers, and finally they have no choice but to go to the hospital. Therefore, we advise our patients to go to the neurosurgery department (or neurology department) of the hospital once they have recurrent unilateral facial pain, which is usually diagnosed at the county or city hospital. The next step is not to rush to take medicine, but first to figure out the cause of the disease. It is believed that the cause of most trigeminal neuralgia is not yet clear and is called primary trigeminal neuralgia. It is generally believed that it is due to vascular compression of the trigeminal nerve root leading to demyelinating lesions forming a short circuit in nerve conduction. Some patients are caused by other cranial diseases, such as tumors, cysts, inflammation, etc., which are called secondary trigeminal neuralgia. Therefore, patients with trigeminal neuralgia should undergo cranial magnetic resonance imaging (MRI) and CT examinations before treatment to exclude and treat these lesions. For patients with new onset of trigeminal neuralgia, oral medications such as carbamazepine, lamotrigine tablets and other antiepileptic drugs are usually used, but the effect is significant in the short term, but over time, the efficacy of the drugs will become less and less effective, and will cause liver and kidney damage, which often outweighs the loss. Professor Sun Hongtao has cured more than 2000 patients with trigeminal neuralgia and facial spasm since he started microvascular decompression, and has accumulated valuable clinical experience.